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11/19/09

Climate change is the century’s biggest health threat to children, says a new study.

At first glance, the 2009 World Bank country overview for India reveals an encouraging snapshot. Since Independence, absolute poverty has declined by more than half (rural poverty 28 percent and urban poverty 26 percent), life expectancy has doubled to 64 years, the current fertility rate is 2.5 percent and primary school enrolment is at 90 percent.Then come the child and maternal health statistics and your face drops. Almost half of our under-five year olds are malnourished (46 percent). Despite gains, infant mortality remains among the highest in the world (57 deaths per thousand births) and maternal mortality is still at an astonishing 450 deaths per 100,000 births.

India’s schizophrenic development profile isn’t easily understood or explained, sometimes even by health experts. It does, however, beg another question: if we are already lagging so far behind with providing access to quality health care for our children and mothers, how well prepared are we to deal with the foremost challenge of this century — climate change — which, according to a new Save the Children report, will greatly exacerbate the diseases that already kill children in large numbers – diarrhoea, malaria and malnutrition.

Take the case of diarrhoea – an easily preventable and treatable disease. Yet, it kills 2 million children worldwide, including an estimated 85,000 due to climate change ever year, says the new report. Scientists from the Intergovermental Panel on Climate Change have warned that rising temperatures will coincide with more frequent and ferocious storms. As if on cue, last year, Cylcone Aila hit soon after Cyclone Nargis, swept up surges four to eight feet higher than normal and ravaged the Sundarbans. Poor families are still reeling from the impact.

“Obviously, it affected a huge number of children in the area,” says Manabendra Nath Ray of Save the Children, West Bengal. “But there is still a lack of understanding. Recurring cyclones are not being interpreted as climate change.” The government’s secondary level health infrastructure — ideally the backbone for health outreach to villages — was poor to begin with. With Cyclone Aila, it took a further hit. “Several ICDS (Integrated Child Development Services) centres were submerged and some remained closed for more than a month,” says Ray.

Malaria is similarly a major cause of child morbidity, especially in central India. Coupled with a change in land use patterns, population growth rate and deforestation, climate change will increase the incidence of vector-borne diseases such as malaria and dengue fever, the report says. “Erratic rains, stagnant puddles and zero mosquito control increased the cases of malaria and dengue fever,” says a public health expert who has worked in Madhya Pradesh for more than a decade. Insecticide-treated nets substantially reduce the chances of contracting vectorborne diseases. Government officials say they are directly distributing them to beneficiaries even though they’re not visible to health practitioners on the ground.

The hunger capital of India, MP was doubly impacted this year by the worst drought in the country in 37 years. “Since farming is the main occupation, malnutrition increased a lot,” says Neelesh Garg, district programme manager for Jabhua — a district with among the highest malnutrition rates in MP. “Since October, the Bal Shakti Yojana has controlled the situation,” he added.

“I do commend the government’s schemes, but they just aren’t enough,” says the MP-based public health expert. “Bal Shakti Yojana provides for only 50 beds in the entire district and obviously there were a lot more cases of disease. The whole effort just needs to be much more decentralised, community-based, massive and organised.”

new book — Malnutrition, an Emergency: What it Costs the Nation — estimates that malnutrition costs India 4 percent of its GDP. But the book’s author, Veena Rao, conversely also offers this: in the next two years, if we reduce malnutrition by a quarter, which is quite possible because half of malnutrition is not due to poverty but from lack of awareness, then India can increase its GDP by 1 per cent.

If moral and climate-induced compulsions are not enough to drive change, at least economic ones should be.